Konakion
Generic Name
Phytomenadione
Manufacturer
Roche
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| konakion 2 mg injection | ৳ 98.00 | N/A |
Description
Overview of the medicine
Konakion 2 mg injection/oral solution contains phytomenadione, a synthetic form of Vitamin K1. It is primarily used in neonates and children to treat or prevent bleeding disorders caused by Vitamin K deficiency and to reverse the anticoagulant effects of drugs like warfarin.
Uses & Indications
Dosage
Adults
For rapid reversal of warfarin effect: 0.5-10 mg intravenously depending on INR and bleeding severity (usually higher doses of 10mg are used, but 2mg may be sufficient for milder cases). For severe Vitamin K deficiency: 10 mg IM/SC daily until normal coagulation achieved (usually using the 10mg/mL formulation).
Elderly
Same as adults, but lower doses may be considered for reversal of warfarin effect to avoid overcorrection.
Renal_impairment
No specific dose adjustment is generally required.
Paediatric_neonates
For prevention of Vitamin K deficiency bleeding: 1 mg IM or IV at birth. For treatment of established Vitamin K deficiency bleeding: 1-2 mg IV or SC (the 2mg/0.2ml paediatric formulation is suitable). For reversal of warfarin effect: 0.5-2 mg IV, adjusted according to INR.
How to Take
Konakion 2 mg/0.2 mL solution can be administered intravenously (IV), intramuscularly (IM), subcutaneously (SC), or orally. IV injection should be slow, over at least 30 seconds, especially to minimize the risk of severe reactions.
Mechanism of Action
Phytomenadione is a fat-soluble vitamin essential for the hepatic synthesis of active prothrombin (Factor II), proconvertin (Factor VII), plasma thromboplastin component (Factor IX), and Stuart factor (Factor X). It also participates in the carboxylation of proteins C and S. It serves as a cofactor for the enzyme gamma-glutamyl carboxylase, which converts specific glutamic acid residues in these clotting factors to gamma-carboxyglutamic acid residues, enabling them to bind calcium and participate in coagulation.
Pharmacokinetics
Onset
Intravenous: 1-2 hours for effect; measurable PT changes within 3-6 hours. Subcutaneous/Intramuscular/Oral: longer, up to several hours.
Excretion
Primarily excreted in bile and urine after hepatic metabolism.
Half life
Approximately 1.5-3 hours for plasma elimination.
Absorption
Well absorbed after intramuscular or subcutaneous injection, especially if bile salts are present. Intravenous administration provides immediate systemic availability. Oral absorption of the 2mg/0.2ml solution is also good.
Metabolism
Rapidly metabolized in the liver to more polar metabolites, which are then conjugated and excreted.
Side Effects
Contraindications
- Hypersensitivity to phytomenadione or any component of the formulation.
- Severe hepatic impairment (relative contraindication for high doses in some contexts).
Drug Interactions
Mineral Oil/Cholestyramine
May impair absorption of oral Vitamin K. Not directly relevant for parenteral Konakion, but important for dietary Vitamin K intake.
Oral Anticoagulants (e.g., Warfarin)
Phytomenadione is a direct antagonist to coumarin anticoagulants. Concurrent administration will rapidly reverse their anticoagulant effect. Close monitoring of INR is crucial.
Storage
Store below 25°C. Protect from light. Do not freeze.
Overdose
Overdose is rare due to rapid excretion and low toxicity. High doses can lead to transient liver dysfunction, hemolytic anemia (in G6PD deficient individuals), and hyperbilirubinemia in neonates. Management is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Used when clinically indicated, especially for treatment of fetal coagulopathy or in pregnant women on anticonvulsant therapy. Phytomenadione is distributed into breast milk in small amounts; generally considered compatible with breastfeeding at therapeutic doses, but caution is advised and benefits/risks should be weighed.
Side Effects
Contraindications
- Hypersensitivity to phytomenadione or any component of the formulation.
- Severe hepatic impairment (relative contraindication for high doses in some contexts).
Drug Interactions
Mineral Oil/Cholestyramine
May impair absorption of oral Vitamin K. Not directly relevant for parenteral Konakion, but important for dietary Vitamin K intake.
Oral Anticoagulants (e.g., Warfarin)
Phytomenadione is a direct antagonist to coumarin anticoagulants. Concurrent administration will rapidly reverse their anticoagulant effect. Close monitoring of INR is crucial.
Storage
Store below 25°C. Protect from light. Do not freeze.
Overdose
Overdose is rare due to rapid excretion and low toxicity. High doses can lead to transient liver dysfunction, hemolytic anemia (in G6PD deficient individuals), and hyperbilirubinemia in neonates. Management is supportive and symptomatic.
Pregnancy & Lactation
Pregnancy Category C. Used when clinically indicated, especially for treatment of fetal coagulopathy or in pregnant women on anticonvulsant therapy. Phytomenadione is distributed into breast milk in small amounts; generally considered compatible with breastfeeding at therapeutic doses, but caution is advised and benefits/risks should be weighed.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 3-5 years from manufacture, refer to specific product labeling for exact expiry.
Availability
Hospitals, Pharmacies
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Phytomenadione is a long-established essential medicine. Extensive clinical trial data from its early development and subsequent widespread use supports its efficacy and safety. Recent clinical trials tend to focus on specific applications, patient populations, or comparisons with other agents rather than primary efficacy.
Lab Monitoring
- Prothrombin time (PT) / International Normalized Ratio (INR) – to assess coagulation status and guide dosing.
- Liver function tests (LFTs) – if liver dysfunction is suspected, especially in neonates.
- Complete Blood Count (CBC) – if hemolytic anemia is a concern (e.g., in G6PD deficient individuals).
Doctor Notes
- Always check INR before and after administration to guide subsequent dosing, especially when reversing anticoagulant effects.
- Ensure slow IV administration to minimize the risk of anaphylactoid reactions, and consider dilution.
- Be aware of the potential for temporary resistance to oral anticoagulants after high doses of Vitamin K, requiring careful re-initiation or adjustment of anticoagulant therapy.
- The 2 mg/0.2 mL formulation is particularly suitable for paediatric use, including oral administration for neonates.
Patient Guidelines
- This medicine will be administered by a healthcare professional.
- Inform your doctor about all medicines you are taking, including over-the-counter drugs and herbal supplements.
- Report any unusual bruising, bleeding, or allergic reactions to your doctor immediately.
- If given orally to an infant, ensure the full dose is swallowed.
Missed Dose Advice
This medicine is usually administered by a healthcare professional in a hospital or clinic setting. If a scheduled dose is missed, contact your doctor or nurse immediately to reschedule or determine the next course of action.
Driving Precautions
Konakion is not known to impair the ability to drive or operate machinery. However, if you experience dizziness or other side effects, avoid driving or operating machinery until you feel well.
Lifestyle Advice
- If you are also taking oral anticoagulants, maintain a consistent diet to avoid fluctuations in Vitamin K intake. For injected Konakion, no specific dietary changes are typically required.
- Avoid activities that may lead to injury and bleeding if you are susceptible to bleeding, as advised by your doctor.
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